Tips For Surviving Nursing: The Trauma Of Caring

I'm pretty sure my first post here was maybe in a newly recovering addict. After 34 years in this profession, mostly in PICU and nearly 98% pediatrics, I realized today that I am indeed traumatized by my past. I came online looking to see if I was alone. But it is not due to abuse within my family.

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Today I remembered a 4 yr old... lifeless, so pale, except for the bruises which covered his body. I remember so vividly the parent who angrily confessed that "the boy just refused to walk right" he beat him to death. I thought about the terror that child must have felt just before he lost consciousness.

I remembered the tiny little boys we (PICU RN's) referred to as 'the blues brothers' because of the constant cyanotic spells requiring resuscitation, who all ultimately succumbed to their respective disease states. So many infants born of addicted mothers....left...just the PICU to be cared for by us. No family, ever.

A beautiful, fat, porcelain-skinned six months old transferred to us from the NICU...a graduate they called her. She was physically perfect except for a trach which was, apparently, more than her birth mother could cope with. Her life void of any bonding, this child had developed an aversion to human interaction. Months of patient coaxing finally led to eye contact and then to an earth moving smile from her. In my first work-related nightmare I stole this baby...and then frantically tried to figure out how to return her before getting caught. People ask "how can you keep from getting attached?" We couldn't do our jobs without getting attached.

How many mother's faces I looked into as I laid their already lifeless child in their arms after I took them away from the machines which made them seem alive for a while...sometimes very long whiles. How many times I hurt a child in the name of treatment which we all really knew was futile. Oh my God, that one hurt.

I remember feeling guilty about the joy I felt as one family lost a perfectly healthy child to a GSW to the head because another child would live ...perhaps...even though it would mean a life-long regime of medications, physician visits, lab tests, fear of rejection.

The broken hearts of family members over a brain-dead child due to shaken baby....the sorrow I felt because he really didn't know the consequences of his actions....the rage I felt because a mother lied while her baby was dying because she didn't want to get her boyfriend in trouble for his abuse of that child.

I am thinking how there seems to be an invisible wall which surrounds the bedside of a dying child; all the cacophony of PICU noises dulled by broken hearts and pulled curtains.

So many times I was so angry yet so helpless to make a difference.

Burns, abuse, accidents, mistakes, every disease known to afflict adults, head trauma, heart trauma, multi-trauma, multi-system-organ-failure, limbs lost, lives changed, slow deaths, traumatic deaths, anticipated deaths, unexpected deaths, and deaths which didn't happen; all have taken a toll.

There were miracles, yes. There were triumphs, many.

But today I realize, I am traumatized. I will not return to substance abuse...which is how I suppose I lived through it all. But I am asking for your prayers as I learn how to begin to deal with this realization: We as caregivers must recognize the effects of our caring on ourselves! My husband knew, but couldn't tell me. He said he saw me hugging my own children too tight and too long for their ages.


Thank you all.

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46 Posts

Specializes in Med-Surg and L & D. Has 1 years experience.

Awesome, heartwrenching, and gut tearing. Your evoked pictures and emotions with your words. Your pain hurts me. I am sorry that you had to experience all of this, but I am glad that you were there for the small victims. I am glad that you survived. Always remember that all of our experiences, bad and good, make us what we are today.

I wish that I could find the words to take away your pain.


100 Posts

Specializes in CNA.

As a mother to twins who spent weeks in a NICU dealing with A&B's to seemingly no end ,and a woman on the road to nursing herself ...let me say a heartfelt thank you for every tear you have ever cried over a patient and remind you how much it means to those on the other side of the bed rail or incubator wall for that matter( parent and or child)....that someone "caring" for them really CARES..please know that wihle it does take a terrible tole on you , your caring attitude might be exactly what a child or parent someday needs to deal with the next obstacle, be that a test or a possible negative prognosis...I am so sorry you hurt with all you have seen but it was nurses lke you who helped me keep my sanity when my babies were in NICU 3 hours from our home... believe me it makes you a better kinder more caring nurse for it and I am sure MANY of your pateints familys have noticed this!

God bless you and all like you ~


115 Posts

Specializes in Addiction & Recovery, Community Health. Has 5 years experience.

Tears in my eyes...

Specializes in general surgical, women's surgery. Has 7 years experience.

I just want to say "thank you" for making yourself open and vulnerable by being a truly compassionate nurse. May God restore a sense of wholeness to you as you realize that anything you feel you've lost through self-sacrifice has ultimately been a gain for so many.... and that you hold within your own heart something so few can claim.... a purpose beyond who has made a positive impact on countless of those who number among " the least of these."

You write beautifully from your heart and are an inspiration to us all. I'm a mature woman (52), but new to the nursing profession. I recently commented to my husband (a physician) that it's easy to become jaded and cynical in this profession and I fear that I am already becoming everything I said I'd never be. Your writing is timely for me, and provokes me to remember WHY I decided to pursue this career in the first place after raising our family.

Thank you.. from my heart to yours.


25 Posts

I have been searching the literature for information on nurses and PTSD and substance abuse and have found little information.

As a nurse I think PTSD is so much a part of our lives that it is easy to become substance abusers - the pace goes on and there is another patient to care for.

This topic needs to be addressed in Nursing curriculum and not to be hidden

Students and new graduates need to be aware that substance abuse is a work hazard given the population and environment where we work.

Any thoughts? Thanks fpr bringin up this subject and again, I will pray for you each day for your continued recovery.

Incidentally there are many nurses who are not in the statistics as substance abusers because they have not abused drugs from work. These nurses become the statistics as they are discovered but think of the number of nurses who drink alcohol, etc. and are under the radar.

sandygator, BSN, RN

1 Article; 37 Posts

Specializes in Pediatrics, ICU, Dialysis.


The problem of substance abuse among nurses is, I am sure, much more prevalent that most people realize. I would think it's largely self-medication of undiagnosed depressive states as was my case. The rehab center at which I was an inpatient was crammed full with MD's and RN's. Not all subatance abuse is with illegal drugs, remember. My drug of choice was alcohol. I previously addressed this problem on one of the forums here...nothing has changed. When is the last time you saw someone at your institution "randomly" drug tested...not someone already under suspicion? At my large university hospital it does not happen.

How many times do your co-workers make reference to alcohol consumption when a crisis is over or on-going? "I need a beer" or "I hear a margarita calling my name" Going out after work for drinks is extremely common. It's a loud warning which is being deliberately overlooked. After all, if they discovered all the nurses abusing/using mind-alteriing substances who would care for the patients?

I know I sound jaded and negative toward nursing, but I have been there for 34 years! I KNOW I am not alone.


502 Posts

Specializes in trauma, ortho, burns, plastic surgery.

YOU are a good nurse dosen't matter what was happen in your past! Sensitive and open, honey, don't look back! This life is soo beuatifull you need to fell it finally. Are people and events new, just to discover them. Be how your soul it is. And YES your soul is addicted to other good people souls and nothing else more. From today start your new life belive in. I will think and pray for you as much more I will can, belive in you and write all the time when somenting is not ok....I am here! ZUzi, a bug who live in Allnurses house hugs you! Muaaaaah honey!


25 Posts


You are so right. I am a recovering alcoholic and have been a nurse for over twenty-six years. When I first started working at a teaching hospital, after codes we would go out for a drink - at 12 or 1am - and think this was normal.

It is so true that nurses discuss what they had to drink, what they will drink.

One nurse was on the floor in front of everyone and said how she felt bad because she drank so much last night. The other nurses nodded like they understood.

As you stated - nurses and all hospital personnel where I have worked at a university teaching hospital, also, have never been randomly tested for drugs - or not randomly for that matter.

I think anyone in a position of effecting another person's life should be tested for drugs.

When I got sober my eyes started opening up at how nurses medicate themselves masking their stressed out emotions and trauma. Maybe this is one of the reasons there are so many strange personalities in Nursing.

I read an article that was written in the late '88 about the high percentage of nurses who are adult children of alcoholics.

Thanks for your comments.

Liddle Noodnik

4 Articles; 3,789 Posts

Specializes in Alzheimer's, Geriatrics, Chem. Dep.. Has 30 years experience.

How did I miss that?? Awesome Sandy one recover-er to another, you are a true survivor. Thank you.


1 Article; 266 Posts

Specializes in Making the Pt laugh..

i am forever gratefull to the staff who work in the neo-natal field for the care given not only to my son but to my wife and myself. born 11 weeks prem and with a lot of the "typical" problems he was a sick little boy. i remember feeling jealosy of the staff who could touch him while he was too small for me to hold, it took 2 1/2 weeks before i could hold him, or while i was at work or looking after my other son, but knew he was in great hands.

while my little boy thrived, (the staff nicknamed him the "dead-set-legend") others in the unit didn't do so well. my wife and i saw the loss felt when the struggle for life ended and could feel the grief in the room. i know that the care offered freely by the staff made the grief harder but hope that the "graduates" bring an equal joy.

my son is now starting high school and plays football and even gets the odd "a" for his schoolwork. the tiny babies can grow up and no-one will know that they had to struggle to live, but their parents remember and they remember the staff that helped during that very hard time. so on behalf of my family and others in a similar circumstance....................... thankyou!!!!!!!!! :flwrhrts:


29 Posts

I want to thank you as well from a mother of a child who spent time in the NICU. I know how you feel. I worked the NICU as a paramedic. God Bless and keep you always. Thank you so much for all that you have done and do.